Politics of 1 Malaysia clinics — John Teo

DECEMBER 16 — That's it, it's politics and nothing else.

1 Malaysia clinics was started by the previous government with the primary aim of bringing basic health services to the urban poor close to their homes. They were staffed by medical assistants and nurses who provide basic health services such as BP check, simple wound dressing, cough and cold medications etc.

The first 1Malaysia Clinic was launched at Lembah Pantai, Kuala Lumpur on January 7, 2010 right in the heart of Klang Valley where the highest density of clinics are found in the nation.

Many question their effectiveness as all these services are already available at existing government health clinics. Besides, there is not much a clinic, without doctors, can provide on medicine that can only be prescribed by doctors and most cases other than simple flu etc will need a doctor to manage and review.

Private doctors have always appealed that it would have been better to use the many existing private clinics that are found in every densely populated areas as collaborators in delivering these services or offer locum positions for private doctors in 1 Malaysia clinics.

Eight years on, it has clearly been shown that 1 Malaysia clinics in its original form served little purpose and many are being utilised as cheap “pharmacies” for simple remedies, the same service that can be easily obtained from the many existing private clinics or pharmacies at similar costs paid by the government or even lower costs on certain occasions.

Recent revelations by Datuk Dr Lee Boon Chye, the Deputy Minister of Health, proved the point. “The cost of operations for all these clinics was RM119 million for the period, or an average of RM18 per patient,” he said.

This is the cost for medicines, reagents and consumables, and does not include operation costs for the manpower and rentals of premises.

Realising that clinics without doctors would serve little purpose, the current government had now rebranded them as community clinics and planning to station medical officers and pharmacists in stages, thus upgrading the services available.

Out of the 347 clinics, 34 will be closed , 20 upgraded to government health clinics and 293 rebranded as community clinics.

This is a step in the right direction But the concern is of course the heavy financial burden of maintaning the 293 community clinics duplicating the services of the private clinics as well as existing government health clinics.

Private sector data revealed that on average the fixed costs of running a clinic ranges from 20K to 30K per month for a clinic operating 9-10 hours per day depending on locality. These fixed costs include staff salaries, rental of premises, utilities, stationaries, licensing and associated charges etc but do not include doctors' salaries.

With the 293 Clinics, it would cost the government an estimated RM70 million to RM105 million annually in addition to the RM119 milion of consumable costs.

The cost efficiency of this huge annual allocations can be significantly improved if we take advantage of economies of scale and shared common resources. This would mean we close all 1 Malaysia clinics and consolidate them into regional health clinics or klinik kesihatan.

By doing so, we cut costs with shared facilities and staff rather than maintain so many small clinics duplicating services everywhere with each clinic needing to have its own set of staff, utilities etc.

Again, it would not be a popular political move to close all 1 Malaysia clinics especially when they are meant to serve the B40, a large and underserved group, despite that they would be, in reality, better served economically by bigger, more cost efficient consolidated facilities.

When we stop playing politics with healthcare, the people's health improves and the nation will be in a better position to progress.

I hope one day, politicians and the government will take that position and say no to politics in healthcare.

* This is the personal opinion of the writer or publication and does not necessarily represent the views of Malay Mail.

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